Extreme Conditioning:Popular But Risky?

Extreme conditioning programs (ECPs) promise vastly improved fitness in relatively short periods of time, which appeals to a cross-section of the U.S. civilian and military populations. Yet many health professionals fear that these high-powered, widely marketed programs increase the risk of musculoskeletal injuries.

Michael Bergeron, PhD, and colleagues summarized the controversy over ECPs in 2011. While their report focuses on issues central to preparing U.S. soldiers for combat missions, it provides broad guidance to fitness professionals who are participating in or leading ECPs.

What Are the Benefits of Extreme Conditioning Programs?

Many ECPs are designed to employ high-intensitymetabolic conditioning, which Bergeron et al. describe as exercises that “impose a moderate to high demand on the cardiovascular system and energy metabolism of the active muscle fibers to meet with the muscles’ repeated high-energy requirements.” Observed benefits of using these programs include reduced body fat, increased local muscular endurance and increased cardiovascular capacity (Bergeron et al. 2011).

Another focus of extreme conditioning is functional fitness. To this end, ECPs concentrate on a person’s ability to perform whole-body (or multijoint) movements repeatedly under highly fatiguing conditions (Bergeron et al. 2011). The multifaceted nature of ECPs leads participants to believe they are getting benefits beyond those gained through typical physical fitness programs, say Bergeron and colleagues. And many soldiers believe that ECPs not only increase combat readiness (as mentioned above) but also enhance camaraderie and teamwork. These beliefs heighten the appeal of individual and/or group ECP sessions.

Injury risk also increases when exercise sessions become competitive. For example, military personnel and exercise enthusiasts in a class often seek peer approval by attempting to keep up with others who may be fitter and stronger. In recreational sports conditioning, where training as a team is very important, this same mindset occurs. Individuals are often encouraged to push themselves unknowingly to excess, leading to a greater potential for injury. In a team setting, it becomes difficult to scale back.

Although individual pacing and progression are essential for proper fitness development, respect for these guidelines is often perceived as a sign of weakness (Bergeron et al. 2011). The overreaching phenomenon may be more common in entry-level participants in ECPs.

Recommendations to Improve ECP Safety

So what can you take away from this research and implement to keep your clients safe if you are doing ECP with them?

Reducing injury risk and improving the implementation of extreme conditioning programs are of paramount importance. Among Bergeron and colleagues’ recommendations for safe ECPs:

Plan regularly scheduled days of reduced or no supplemental conditioning, especially in more active populations such as the military and recreational athletes.

Watch for preworkout use of caffeine and products containing substantial levels of caffeine, such as popular energy drinks. Use should be discouraged, as caffeine can easily mask fatigue, leading to overreaching and overexertion.

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About the Authors

Len Kravitz, PhD, is the program coordinator of exercise science and a researcher at the University of New Mexico in Albuquerque, where he recently won the Outstanding Teacher of the Year award. Len was also honored as the 2006 Fitness Educator of the Year by the American Council on Exercise.